title: Childhood trauma and dissociation in first-episode psychosis, chronic schizophrenia and community controls.
abstract: Increasing evidence supports the role of childhood trauma in the etiology of psychosis but underlying mechanisms are poorly understood. Early maltreatment has been linked to dissociative symptoms in psychosis patients. We explored associations between childhood trauma (Childhood Trauma Questionnaire) and dissociation (Dissociative Experiences Scale) in first-episode psychotic patients (n=62), chronic psychotic patients (n=43), and non-psychotic community controls (n=66). Multivariate analyses of covariance were used to test associations between childhood trauma and dissociation by group while controlling for sex. Chronic patients reported the highest level of dissociation. More severe childhood trauma was associated with greater dissociative symptoms in all groups although most strongly in chronic patients. Emotional abuse showed the strongest associations with dissociation, with these being strongest for chronic patients, followed by first-episode patients--and least for controls. Men showed a stronger association between physical neglect and dissociation than women, irrespective of group. There were no significant group by sex interactions. Our findings replicate the strong association between childhood trauma and dissociative symptoms in chronic and first-episode psychotic patients relative to non-psychotic control subjects. We also demonstrate the salience of emotional abuse in explaining variance in dissociation, especially in chronic patients.
authors.affiliation: University of Glasgow, Institute of Health and Wellbeing, Glasgow, United Kingdom.
authors.forename: Christine
authors.initials: C
authors.lastname: Braehler
authors.forename: Luc
authors.initials: L
authors.lastname: Valiquette
authors.forename: Darren
authors.initials: D
authors.lastname: Holowka
authors.forename: Ashok K
authors.initials: AK
authors.lastname: Malla
authors.forename: Ridha
authors.initials: R
authors.lastname: Joober
authors.forename: Antonio
authors.initials: A
authors.lastname: Ciampi
authors.forename: Nicole
authors.initials: N
authors.lastname: Pawliuk
authors.forename: Suzanne
authors.initials: S
authors.lastname: King
mesh_terms: D000293:Adolescent; D000328:Adult; D002649:Child Abuse / Q000523:psychology; D002908:Chronic Disease / Q000523:psychology; D004213:Dissociative Disorders / Q000150:complications* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000209:etiology* / Q000523:psychology; D012111:Residence Characteristics; D012559:Schizophrenia / Q000209:etiology*; D012565:Schizophrenic Psychology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Childhood abuse; Childhood neglect; Emotional abuse; Physical abuse; Physical neglect; Psychosis; Sexual abuse